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Dental One Associates of Toco Hills
2882 N Druid Hills Road NE, Suite A, Atlanta, GA 30329

Medicare Advantage Dental Benefits in Atlanta

Are you a senior over the age of 65 searching for dental treatment? Many seniors need dental benefits in Atlanta to improve their health, but they’re also the segment of the population least likely to have access to affordable dental care. Once seniors leave the workforce, they often lose medical insurance coverage, which can include dental coverage as well. In fact, nearly two-thirds of seniors go without coverage, and this number will rise as more and more Americans turn 65. This leaves many seniors searching for budget-friendly options for their dental needs.

Even without dental insurance options, spending on dental care among seniors reached $28 billion in 2016. Seniors also represent the highest spending growth rate among any segment of the population, and more seniors visit the dentist every year – the American Dental Association Health Policy Institute found that 6 million more seniors saw the dentist in 2016 than in 2006. Despite a rise in spending, nearly half of Medicare recipients avoided the dentist altogether last year, according to a Kaiser Family Foundation study. Among those who did receive care, 19% spent more than $1,000 out of pocket. Here are some of the typical costs of dental procedures:

Checkups and Cleanings:

  • Basic exam–$50 to $100
  • Dental X-ray–$20 to $250
  • Standard cleaning–$70 to $200


  • Silver amalgam–$50 to $300
  • Composite–$90 to $450


  • Simple extraction–$75 to $450
  • Surgical extraction–$150 to $650
  • Wisdom tooth extraction–$75 to $3,000 based on the number and complexity of the extractions


The cost of a crown can range from $500 to $3,000 based on the type of material used.

Root Canals:

The cost of a root canal can range from $300 to $2,000 based on the location of the tooth and the complexity of the procedure.

Do Seniors Have Options for Dental Insurance?

All Americans over age 65 or those who are considered permanently disabled receive healthcare coverage through Medicare. Medicare is a national health insurance program provided by the United States government, and enrollees receive a red, white, and blue ID card. While Medicare covers many medical exams and procedures, it does not provide benefits for dental exams, cleanings and other treatment. However, some dental treatment is covered under Medicare Part A benefits if they’re deemed necessary as part of another covered treatment. One example is Medicare covering an oral examination if it’s required for presurgical clearance.

If dental treatment is necessary, seniors may seek other types of dental benefits in Atlanta. Standalone dental insurance is one option, and 10% of seniors are enrolled in a plan. Additionally, a quarter of seniors will enroll in a Medicare Advantage plan provided by a private company.

What Is a Medicare Advantage Plan, and How Does it Work?

Provided by a private company, Medicare Advantage plans supplement your existing Medicare benefits by expanding the provider network and offering you more healthcare options. These optional plans also include price protection measures, such as low deductibles, spending limits for out-of-pocket expenses, and measures for cost sharing. While the government reimburses treatment costs under traditional Medicare, costs incurred with an Advantage plan are reimbursed by the insurer. Some of the most popular Advantage plan providers include UHC, Aetna, and Humana.

With their low premiums, Medicare Advantage plans make sense for many seniors on a budget. In 2018, seniors paid an average of a couple hundred dollars annually for an Advantage supplement. With a Medicare Advantage plan, you’ll also receive cost-saving benefits on vision services as well as prescription drugs. It’s important to note, however, that these plans don’t typically offer benefits for more extensive dental procedures. Most Advantage benefits are limited to preventive care, including dental exams, cleanings, and X-rays, so the plans are ideal for those who simply require maintenance services. When you enroll, you’ll receive an ID card similar to a typical insurance card to present at the provider.

How Do I Decide Between Medicare Supplements and Standalone Insurance?

If you have extensive dental health issues or need more comprehensive coverage, a standalone dental insurance plan might be right for you. These plans are also available through private insurance companies, who offer varying levels of coverage. Your monthly premium as well as the percentage of treatment cost covered will depend on what plan you select. Here are a few examples of common standalone dental plans:


The lowest level of coverage, which includes preventive care like oral examinations, mouth cancer screenings, and professional cleanings. Diagnostic X-rays are also typically included.


Mid-level plans usually offer a broader range of coverage, including emergency dentistry, braces, more specialized X-rays, nitrous oxide sedation, fillings, and dentures.


The highest level of coverage, premium plans provide at least partial benefits for advanced dental treatment. These plans are ideal for those with more serious dental health issues. Some of the services covered by premium plans include:

  • Dental inlays and onlays
  • Tooth crowns
  • Endodontic treatment
  • Dental surgeries
  • Complete and partial dentures
  • Periodontal care

Private dental coverage is usually tiered under a 100-80-50 system. This means that most preventive care is fully covered at 100%, routine procedures are covered at 80%, and more complicated treatment receives 50% coverage. According to Bankrate’s data, Americans spend an average of $350 on private plans each year. This may be slightly lower than an Advantage plan premium, but it’s important to remember that private plans don’t include eye care, hearing, and medication benefits.

Is a Dental Discount Plan an Insurance Alternative?

If you are in generally good dental health and are hoping to save on routine care, a dental discount plan can be an excellent choice. Providers that accept dental discount plans agree to accept lower rates for services, which are negotiated by the discount company. The dental discount provider then passes the savings on to members for a small monthly fee and a one-time enrollment fee.

Generally, discount plans are quite affordable, and offer several benefits over private insurance:

  • Discount plans have no deductibles, coinsurance requirements, or copays
  • There are no waiting periods, meaning you can see a dentist right away
  • You can choose a new dentist at any time
  • There are no claim forms or paperwork to fill out when receiving benefits
  • Discount plans do not have age limits or exclusions for pre-existing dental health issues

While dental discounts may not cover as many procedures as traditional insurance, they can lower the cost of common services, such as:

  • Routine dental checkups
  • Professional cleanings
  • X-rays
  • Tooth extractions
  • Tooth crowns and fillings
  • Dentures

Many popular discount plans, including DentRite®, feature discounts at eye care centers and on medications as well. If you’ll only require routine checkups and procedures to keep your teeth healthy, you may wish to consider this option. However, those requiring extensive dentistry may need a more traditional insurance plan.

Do Dentists Provide Payment Options for Dental Expenses?

Flexible financing options can make dental costs more manageable for families on a budget. One popular choice is CareCredit, which is accepted at 200,000 healthcare facilities nationwide. Many financial companies offer short-term financing with no interest if the balance is paid off within a specified period of time. Larger purchases may also qualify for long-term financing of more than 60 months. Keep in mind that applying for financing does have drawbacks, including:

  • An application and approval process – not every person is qualified for financing
  • Interest rates can be between 15-20%, adding to the overall treatment cost

If you have questions regarding dental benefits in Atlanta, supplement plans, or the discounts and financing options available to you, there are resources that can help. The AARP, local senior organizations, and our office are available to answer your questions. Contact us now for more information.

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Dental One Associates of Toco Hills

2882 N Druid Hills Road NE, Suite A, Atlanta, GA 30329

(404) 410-7841